Development

Children need much more sleep than adults, and not getting enough affects their attention, concentration, reasoning and problem-solving – everything that is required for them to perform well in school, says Dr Chong Yaw Khian, chief of Sleep Disorder Services at Tan Tock Seng Hospital, National Healthcare Group.

Sufficient sleep also keeps the memory in top-notch condition. Without it, it is harder for your child to remember what he learnt and experienced during the day, he adds.

Here, we get the sleep experts to share six things that can sabotage a good night’s rest for Junior, and tips to fix them.

Your kid is too tubbyDoes Junior snore at night and appear very sleepy in the day? A good night’s rest can remain elusive if your child is too fat.

Obesity can cause a condition called Obstructive Sleep Apnoea (OSA), experts say. This occurs when your child repeatedly stops breathing when he is asleep, and cuts off oxygen to his vital organs like the brain and heart.

This sleep disorder is particularly detrimental for growing kids as getting sufficient oxygen is critical for their growth and brain development, TTSH’s Dr Chong shares.

About a fifth of obese kids may get it as they have more fatty tissue in the throat and neck, which affects airflow during breathing, says Dr Theodric Lee, a paediatrician at Thomson Paediatric Centre with a special interest in respiratory and sleep medicine.

Breathing, especially during sleep, may also require more effort when there is excess chest and stomach fat, he adds.

Kids may get OSA due to enlarged tonsils and adenoids (the patch of tissue sitting at the back of the nasal passage), which are hereditary.

What to doGet your kid’s excess weight in check. To do this, there is no quick fix, says Dr Lee. “Parents have to promote a healthy lifestyle, including a healthy and well-balanced diet, avoid snacking and sweetened beverages,” he says.

Getting your kid’s sleep habits in order is as important as combating obesity. A study found that teens who regularly slept less than six hours per night were 20 per cent more likely to become obese by the time they reached 21, Dr Chong shares.

If you suspect that your child has OSA, take him to see a sleep specialist, he advises. Your child might be required to undergo an overnight sleep study known as an overnight polysomnography (PSG), says Dr Lee.

This requires him to be monitored overnight in a paediatric sleep lab by sleep technicians and assessed by doctors trained in paediatric PSG.

“For kids with OSA due to enlarged tonsils and adenoids, surgery to remove the adenoids and tonsils is the first-line treatment and is a cure for majority of the cases,” says Dr Lee.

There are also other non-invasive methods like having your child use a continuous positive airway pressure machine to keep the airways open while he sleeps.

The wrong food and drinks at the wrong timeA cup of bubble tea in the evening after tuition class, soft drinks at dinnertime and some cookies before bedtime. Before you know it, your kid’s wide awake at bedtime.

The wrong food and drinks can interfere with Junior’s sleep, experts say. For example, bubble milk tea and soft drinks contain high sugar content and are stimulants.

Not only do high sugar foods cause obesity, they also cause insulin surges in the body, which affect your child’s quality of sleep, Dr Chong explains.

Any food taken too near bedtime can affect the sense of restful sleep, he adds.

“Particularly bad are cookies and sugary snacks. They have a high glycemic index (GI) which worsens gastric production,” says Dr Chong.

High GI food is digested and absorbed into the body more quickly, and causes blood sugar surges.

What to doAvoid feeding your kid a heavy meal about three to four hours before bedtime, and offer healthier beverage alternatives, Dr Chong says.

Hold the energy and sports drinks, too. If your kid needs to rehydrate after running around at the playground or after his co-curriculum activity in the evening, stick to plain water.

Sports drinks typically contain large amounts of stimulants like caffeine, and most kids engaging in routine physical activity don’t need them, says the American Academy of Pediatrics.

It warns that some cans of energy drinks can have more than 500mg of caffeine – equivalent to 14 cans of soft drinks.

Too much screen time and not enough outdoor timeYour kid may prefer the iPad, but getting outdoor time matters when it comes to his health, including promoting good sleep. Spending time in daylight helps to regulate our body clock, which tells us when to wake and fall asleep.

On the other hand, spending too much time in front of blue light from the smartphone or computer near bedtime tricks the brain into thinking it is still daytime, Dr Chong warns.

“This means your child may feel wide awake when he should be winding down for sleep,” he says.

What to doYour child needs daylight in the morning to set his body on “alert” mode, so soak up some sunshine outdoors after waking, Dr Chong says. Try walking to school or to the MRT station.

Avoid bright lights two hours before sleep, Dr Lee adds. Switch off gadgets, such as the TV, computer screens and smartphones.

This includes Junior’s high-tech wrist band that links up to his smartphone and monitors his sleep cycle. Rather than help your kid sleep better, many sleep experts believe they cause more stress and interfere with sleep instead, Dr Chong shares.

What to doThere is no one-size-fits-all sleeping arrangement for families, Dr Lee says.

“Parents have to consider their values and preferences, as well as physical environment, such as the number of rooms in the house, and decide what is best for them and their child,” he adds.

For example, if you don’t mind sharing a room with your toddler, but want to move him from your bed, consider using a mattress or bed in the same room.

More importantly, establish a conducive sleep environment and good sleep habits. It is best to keep the room quiet, darkened and around 24 deg C, Dr Chong shares.

“If there are several people in the room, then everyone should practise the same habit at bedtime, such as lights off at the same time, keeping quiet and refraining from doing things that will disrupt another person’s sleep,” says Dr Chong.

You let your kid “catch up” on sleep over the weekend and during the holidaysEver wondered why it is so difficult to get Junior to wake on Monday mornings? It is a sign that his body’s natural rhythm has been thrown out of sync, no thanks to those long morning lie-ins and afternoon naps over the weekend, Dr Chong shares.

“It is a myth that kids will just fall asleep when they are tired and don’t need a fixed bedtime,” he adds.

When your usual sleep routine is messed up, the body’s biological clock may still be in deep sleep and is not ready to wake at the time the alarm goes off.

“Most people assume school holidays and weekends are a great time to catch up on missed sleep. But changing the sleep routine in this manner actually tends to leave one feeling disorientated and irritable, rather than rejuvenated,” explains Dr Chong.

What to doReset your child’s body clock by going to bed earlier a few days before the holiday break ends. If he stays up late on Friday night, try getting him to go to bed earlier on Saturday night, Dr Chong advises.

If that fails, and you’ve not had a chance to get your kid’s sleep schedule back to normal before Sunday night, Dr Chong suggests getting him to go to bed an hour earlier than usual on Sunday night to prepare him for the waking time change.

In the morning, don’t let Junior snooze even if you’re tempted to let him catch five more minutes of sleep. Dr Chong says this may cause the person to enter deep sleep, which is harder to wake from than the light sleep that occurs an hour before the body naturally wakes.

He’s doing strange things in his bedInstead of sleeping peacefully, why is your kid crying and screaming in fear, or up and about at night behaving bizarrely, like peeing in the cupboard?

Parasomnias like sleepwalking, nightmares and night terrors are relatively common among kids, says Dr Lee. About 15 per cent of kids sleepwalk and up to 6 per cent may experience sleep terrors.

These disruptive sleep disorders may run in families, and can be triggered when your child does not get enough sleep or experiences changes in his sleep schedule, for example when he starts school.

A sleep disorder like OSA, fever and illness may also trigger these parasomnias, Dr Lee shares.

What to doIf your kid has a tendency to sleep walk, Dr Lee advises safe-proofing your home by installing gates at the top of the stairway, as well as locking doors and windows to prevent injury.

Stick to regular bedtimes and make sure Junior gets enough sleep. Refrain from waking him when he is in the middle of a sleepwalking or night-terror episode. Instead, guide him to bed without waking him.

“Your child will usually be very disoriented if awoken. It is also unhelpful to discuss the event with your child the next day because he will not remember what happened.

For nightmares, calmly reassure your child that ‘it was only a dream’,” advises Dr Lee.